Acute diarrhea in Baltimore children attending an outpatient clinic

Acute diarrheal illnesses in Baltimore children younger than 2 years of age attending an outpatient clinic were studied during a 12-month period. One in five acute care visits made to the clinic by children younger than 2 years was for diarrhea, and 5% of diarrhea cases required hospitalization. With the use of comprehensive methodology, a potential etiologic agent was identified in the stool of 105 (43%) of the 246 episodes of diarrhea in cases and in 43 (28%) of the 155 controls. Viral pathogens were found in 26% of episodes, and bacterial pathogens were found in 14%. Only rotavirus, enteric adenovirus and Salmonella were significantly associated with diarrhea. Cases were more likely to have measures of socioeconomic deprivation, such as household crowding, low maternal educational level and low birth weight, when compared to controls. Racial differences in morbidity from diarrheal illnesses were observed but could be attributed to these specific sociodemographic factors. Despite the low mortality caused by infantile gastroenteritis in the United States, it remains an important public health problem. However, even with intensive investigation the etiologies remain largely unknown.     

小儿急性腹泻病继发急性假性肠梗阻10例临床分析

小儿急性腹泻病是儿科临床常见病,继发急性假性肠梗阻临床报道较少.收集本院自2005年9月至2007年12月确诊为小儿急性腹泻病继发急性假性肠梗阻10例进行临床分析,现报告如下.     

Aeromonas-associated diarrhea in children

In a 27-month prospective study, Aeromonas spp. were isolated from 7.3% of children with diarrhea and from 2.2% of controls. In 32 patients with diarrhea, ranging in age from 1 to 27 months old, Aeromonas spp. were the only potential bacterial enteropathogens isolated. Principal symptoms of Aeromonas-associated diarrhea were vomiting, fever and bloody stools. Diarrhea was often self-limiting and lasted for 10 days or less in 90% of patients. No secondary spread of diarrhea among close contacts was observed and no clear-cut seasonal patterns of Aeromonas isolation were found. Aeromonas caviae was the most frequently isolated species in fecal samples of patients (24 of 29 isolates) as well as controls (5 of 7 isolates). Cholera toxin cross-reactive cytotoxic enterotoxin was produced by a vast majority of Aeromonas isolates, as compared to a non-cholera toxin cross-reactive cytotonic enterotoxin. In addition no significant correlation was observed between severity of the diarrheal disease and different Aeromonas or the quantity of enterotoxins produced. In our geographic area Aeromonas spp., and A. caviae in particular, seem to be an important and frequent cause of diarrhea in young children.     

儿童肿瘤相关性腹泻

肿瘤相关性腹泻是儿童慢性腹泻的病因之一，多见于神经内分泌肿瘤，也可由其他系统肿瘤引起。腹泻可作为首发症状出现，也可作为伴随症状，其特点是大量稀水样便。患者外周激素、胺和肽类变化是引起腹泻的主要原因。早期诊断是改善预后的关键因素。该文重点介绍了肿瘤相关性腹泻的临床特点和诊断要点，以及各疾病的治疗方法。     

Reducing irinotecan-associated diarrhea in children

Irinotecan is increasingly being used in pediatric oncology. Amelioration of diarrhea associated with protracted irinotecan administration may reduce morbidity and improve dose intensity. In this review, we discuss what is known about the pathogenesis of this toxicity as well as potential predisposing genetic factors. We comprehensively summarize the literature regarding available prevention and treatment strategies, and report data on the use of cephalosporin prophylaxis in 51 patients treated on various pediatric trials. This approach is feasible in children and allows for tolerance of higher doses of protracted irinotecan.     

Travellers�� diarrhea in children

Diarrhea is the most common medical problem affecting all travellers to developing countries. Younger children are at especially high risk of acquiring travellers’ diarrhea and of suffering more severe consequences. Up to 50% of travellers from developed to developing countries can expect to have at least one episode of acute diarrhea during a two-week stay. Episodes of travellers’ diarrhea usually begin abruptly, either during travel or soon after returning home, and are generally self-limited.     

Campylobacter diarrhea in children in Trivandrum

One hundred and fifty two stool samples from patients belonging to the pediatric age group clinically diagnosed as acute diarrhea/dysentery were processed for thermophilic campylobacters.C. jejuni was isolated from 9 samples (5.9%). Five of the C.jejuni isolates were from children who presented with bloody diarrhea and 4 were from those who had watery diarrhoea. Though the pathogenic role of C.jejuni in these cases is not proved, this study indicates the prevalence of the organism in Trivandrum district.     

儿童先天性腹泻与肠病

儿童先天性腹泻与肠病（congenital diarrhea and enteropathies，CODEs）多由单基因突变所致，患儿表现为持续、严重慢性腹泻。CODEs存在诊断延迟、病死率高的问题。结合内镜、组织学检查以及二代测序技术，可对CODEs进行确诊，并进一步开展精准治疗。